IV Sizes?

Published

This is probably a dumb question, but when the IV nurse goes to insert an IV into a patient, what is usually the size of the IV?

I usually go with 18, 20, or 22. I once had to use a 14 gauge. Pushing an iv the size of a drinking straw made me go weak. I apologized over and over, the pt didn't care, had 90% of his body burned.

Up Vote Up Vote ×
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

If you are up on your EBP, the evidence is that smaller is usually better. Small is always better for medication administration. Larger IVs (20GA+) are not indicated for "just in case" anymore as there is simply no need to have a larger bore IV just in case. Larger bore really only indicated for rapid fluid administration. We regularly administer blood through 22ga in my hospital in non critical units.

Up Vote Up Vote ×
Specializes in Emergency Department.
I usually go with 18, 20, or 22. I once had to use a 14 gauge. Pushing an iv the size of a drinking straw made me go weak. I apologized over and over, the pt didn't care, had 90% of his body burned.

I've placed 14 ga catheters before, one of those times being for a severely dehydrated patient in her 70's. That case was quite unusual... but suffice it to say that she needed LOTS of fluid quickly and an 18 ga wouldn't do. As I stated earlier, my go-to's are 18, 20, and 22... but I'm not afraid to place larger catheters if need-be and if I've got to plant one of those bigger catheters, it's because the patient needs the kind of volume and rate that only a very big pipe can provide. Of the roughly 600 IVs I've ever placed, less than a dozen have been the 14 or 16 ga.

If your patient doesn't notice someone pushing the equivalent of a 16p nail into their arm, something is seriously wrong...

Up Vote Up Vote ×
BTW - no question is a dumb question! Just wait until you start priming lines and can't figure out how to get a bubble that's in the middle out.

Bubbles are not harmful and can be safely infused in anyone without an ASD or VSD with a right-to-left shunt. You'll want to flush the tubing, sure, but those little bubbles? Ignore them.

No, they won't "go to the brain and cause a stroke." Review normal blood circulation and see where they'll go. Harmless. It would take 15-20cc in a peripheral vein to do someone harm.

Up Vote Up Vote ×
Specializes in Emergency, Telemetry, Transplant.
Bubbles are not harmful and can be safely infused in anyone without an ASD or VSD with a right-to-left shunt. You'll want to flush the tubing, sure, but those little bubbles? Ignore them.

The harm is from losing my sanity by having to go into the room over and over to silence the "air in line" alarm caused by a 0.3 mL bubble!

Up Vote Up Vote ×
Specializes in Emergency, Telemetry, Transplant.
Larger IVs (20GA+) are not indicated for "just in case" anymore as there is simply no need to have a larger bore IV just in case.

Well, with some ED docs we still have to use the "just in case rule." If that doc can convince the pt. that the pt. was SOB sometime in the last 2 years, the pt will be getting a CTA. :cautious:

Up Vote Up Vote ×
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Well, with some ED docs we still have to use the "just in case rule." If that doc can convince the pt. that the pt. was SOB sometime in the last 2 years, the pt will be getting a CTA. :cautious:

Sure, just because they have MD behind their name doesn't mean they know everything. Lots of doctors are stuck in the past and not up on current evidence and best practices.

Up Vote Up Vote ×
Specializes in Emergency, Telemetry, Transplant.
Sure, just because they have MD behind their name doesn't mean they know everything. Lots of doctors are stuck in the past and not up on current evidence and best practices.

It's not even about current evidence. It's that they cannot possibly r/o a PE without making the patient light up.

Up Vote Up Vote ×
Specializes in Nsg. Ed, Infusion, Pediatrics, LTC.

Fragile hand veins- a 22 inserted without a tourniquet. You do not want to risk blowing what are most likely very frail vessels.

Up Vote Up Vote ×
Specializes in Pedi.

In pediatrics, most peripheral IVs are 22 g or 24 g. A 20 g is HUGE for a kid. I can count on one hand the number of times I've even seen an 18 g and those were always placed by anesthesia. The last time I had an IV (for IV contrast/MRI) it was a 22 g. They recently changed their practice, I guess, because they've always put 20s in me before.

Up Vote Up Vote ×
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
It's not even about current evidence. It's that they cannot possibly r/o a PE without making the patient light up.

Where do your doctors live, 1995? I suspect that you guys must me taking care of a population that has very good health insurance.

Up Vote Up Vote ×
Specializes in Emergency, Telemetry, Transplant.
Where do your doctors live, 1995? I suspect that you guys must me taking care of a population that has very good health insurance.

Based on our patient population…no, not good insurance. Some docs do a great job, but we do have a few that feel that they have to scan something.

Up Vote Up Vote ×
+ Join the Discussion